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Old 12-06-2013, 03:34   #77
ender18d
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Join Date: May 2004
Location: Pineland
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Quote:
Originally Posted by Brush Okie View Post
Mrs. Okie come up with this one. Is it SIRS? If so he is in deep shit.

EDIT-She also says he needs to be checked for VD no matter what.
Yes, this case meets the criteria for SIRS (Systemic Inflammatory Response Syndrome), which are two or more of the following:

> 38oC or < 36oC, heart rate
> 90 beats/minute, respiratory rate
> 20 breaths/minute or PaCO2 < 32
white blood cell count > 12,000 or < 4,000, or > 10% band forms.

SIRS isn't the diagnosis by itself, but an extremely important indicator of severity. Yes, this patient is seriously sick and hence the importance of starting treatment immediately in addition to evacuating him.

I think VD is a very good thought here as well, for two different reasons. First, bugs like neisseria gonorrhoeae can go systemic (usually going for joints rather than bone), and also immunocompromise would predispose the PT to development of an osteomyelitis via this mechanism.
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